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Aadam Z, Kechout N, Barakat A, Chan KW, Ben-Ali M, Ben-Mustapha I, Zidi F, Ailal F, Attal N, Doudou F, Abbadi MC, Kaddache C, Smati L, Touri N, Chemli J, Gargah T, Brini I, Bakhchane A, Charoute H, Jeddane L, El Atiqi S, El Hafidi N, Hida M, Saile R, Alj HS, Boukari R, Bejaoui M, Najib J, Barbouche MR, Lau YL, Mellouli F, Bousfiha AA. X-Linked Agammagobulinemia in a Large Series of North African Patients: Frequency, Clinical Features and Novel BTK Mutations. J Clin Immunol 2016; 36:187-94. [PMID: 26931785 DOI: 10.1007/s10875-016-0251-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/21/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE X-linked agammagobulinemia (XLA) is a primary immunodeficiency caused by Bruton's tyrosine kinase (BTK) gene defect. XLA patients have absent or reduced number of peripheral B cells and a profound deficiency in all immunoglobulin isotypes. This multicenter study reports the clinical, immunological and molecular features of Bruton's disease in 40 North African male patients. METHODS Fifty male out of 63 (male and female) patients diagnosed with serum agammaglobulinemia and non detectable to less than 2% peripheral B cells were enrolled. The search for BTK gene mutations was performed for all of them by genomic DNA amplification and Sanger sequencing. RESULTS We identified 33 different mutations in the BTK gene in 40 patients including 12 missense mutations, 6 nonsense mutations, 6 splice-site mutations, 5 frameshift, 2 large deletions, one complex mutation and one in-frame deletion. Seventeen of these mutations are novel. This large series shows a lower frequency of XLA among male patients from North Africa with agammaglobulinemia and absent to low B cells compared with other international studies (63.5% vs. 85%). No strong evidence for genotype-phenotype correlation was observed. CONCLUSIONS This study adds to other reports from highly consanguineous North African populations, showing lower frequency of X-linked forms as compared to AR forms of the same primary immunodeficiency. Furthermore, a large number of novel BTK mutations were identified and could further help identify carriers for genetic counseling.
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Affiliation(s)
- Zahra Aadam
- Laboratory of Biology and Health URAC34-Metabolic and Immunologic pathology Research Team, Faculty of Science of BenM'sik, King Hassan II University, Casablanca, Morocco
- Institut Pasteur, Human Molecular Genetic Laboratory, Casablanca, Morocco
| | - Nadia Kechout
- Department of Immunology, Institut Pasteur d'Algérie, Faculty of Medicine, Algiers, Algeria
| | - Abdelhamid Barakat
- Institut Pasteur, Human Molecular Genetic Laboratory, Casablanca, Morocco.
| | - Koon-Wing Chan
- Departments of Pediatrics and Adolescent Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Meriem Ben-Ali
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, and University Tunis El Manar, Tunis, Tunisia
| | - Imen Ben-Mustapha
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, and University Tunis El Manar, Tunis, Tunisia
| | - Fethi Zidi
- Department of Pediatrics, Regional Hospital of Tozeur, Tozeur, Tunisia
| | - Fatima Ailal
- Clinical Immunology Unit, Ibn Rochd Hospital, King Hassan II University-AinChok, Casablanca, Morocco
| | - Nabila Attal
- Department of Immunology, Institut Pasteur d'Algérie, Faculty of Medicine, Algiers, Algeria
| | - Fatouma Doudou
- Department of Immunology, Institut Pasteur d'Algérie, Faculty of Medicine, Algiers, Algeria
| | - Mohamed-Cherif Abbadi
- Department of Immunology, Institut Pasteur d'Algérie, Faculty of Medicine, Algiers, Algeria
| | | | - Leila Smati
- Department of Pediatrics, EPH Bologhine, Faculty of Medicine, Algiers, Algeria
| | - Nabila Touri
- Department of Pediatrics, CHU Blida, Blida, Algeria
| | - Jalel Chemli
- Department of Pediatrics, Sahloul Hospital, Sousse, Tunisia
| | - Tahar Gargah
- Department of Pediatrics, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ines Brini
- Department of Pediatrics B, Children's Hospital of Tunis, Tunis, Tunisia
| | - Amina Bakhchane
- Institut Pasteur, Human Molecular Genetic Laboratory, Casablanca, Morocco
| | - Hicham Charoute
- Institut Pasteur, Human Molecular Genetic Laboratory, Casablanca, Morocco
| | - Leila Jeddane
- Clinical Immunology Unit, Ibn Rochd Hospital, King Hassan II University-AinChok, Casablanca, Morocco
| | - Sara El Atiqi
- Clinical Immunology Unit, Ibn Rochd Hospital, King Hassan II University-AinChok, Casablanca, Morocco
| | - Naïma El Hafidi
- Department of Pediatric Infectious Diseases, Avicenne University Hospital, Rabat, Morocco
| | - Mustapha Hida
- Department of Pediatrics, Hassan II University Hospital, Fez, Morocco
| | - Rachid Saile
- Laboratory of Biology and Health URAC34-Metabolic and Immunologic pathology Research Team, Faculty of Science of BenM'sik, King Hassan II University, Casablanca, Morocco
| | - Hanane Salih Alj
- Laboratory of Biology and Health URAC34-Metabolic and Immunologic pathology Research Team, Faculty of Science of BenM'sik, King Hassan II University, Casablanca, Morocco
| | - Rachida Boukari
- Department of Pediatrics, CHU Mustapaha Bacha, Faculty of Medicine, Algiers, Algeria
| | - Mohamed Bejaoui
- National Bone Marrow Transplantation Center, Jebel Lakhdar, Tunis, Tunisia
| | - Jilali Najib
- Clinical Immunology Unit, Ibn Rochd Hospital, King Hassan II University-AinChok, Casablanca, Morocco
| | - Mohamed-Ridha Barbouche
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, and University Tunis El Manar, Tunis, Tunisia
| | - Yu-Lung Lau
- Departments of Pediatrics and Adolescent Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Fethi Mellouli
- National Bone Marrow Transplantation Center, Jebel Lakhdar, Tunis, Tunisia
| | - Ahmed Aziz Bousfiha
- Clinical Immunology Unit, Ibn Rochd Hospital, King Hassan II University-AinChok, Casablanca, Morocco
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